Laserfiche WebLink
1. SEWAGE <br /> Distance to Public Sewers <br /> Does existin septic Connectionrnecessary: iYes No <br /> E P system comply xit,}� Ord. N�49: Yes• No ` Unknown <br /> If no, explain: <br /> Describe septic installation to be installed: <br /> Additional information or comments: <br /> 2. WATER SUPPLY w ' <br /> Is water supplied by privato woll: Yes _•.•• <br /> State deficiency: No Is W03-1 proper:' Yes'. <br /> Does existing or proposed use make this well public water: Yes <br /> Sample of well water taken: Yes No <br /> No ` Date Taken Results <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: ye , o � r'e . T rc�/0ds eOther propoeddisposal <br /> method: <br /> Potential problem: ✓ d? •` <br /> �. FLY, MOS UIM OR VEC DR POTENTIAL <br /> T <br /> State possible vector ? rz <br /> potential & necessary control: <br /> S. AIR POLLUTION PO TEN TIAL <br /> State possible burning or processing <br /> pollutants & necessary control: � <br /> 6. MILET BATff FACILITIES <br /> NO- ''�—' <br /> on existing: <br /> 7. PREVIOUS OPERATION HISTORY Additional facilities needed <br /> d. GE1dERAL SANITATION <br /> State any problems not previously noted: <br /> 9. POPULATION DENSITY <br /> APPx, NO. 1'eople per sq. mi. <br /> /- <br />